Mates watched the passage of President Trump’s “Big Beautiful Bill” in July with alarm. It will slash Medicaid funding by about $1 trillion over ten years—and the “big juicy target” is support for people with disabilities like her son Corbin.

Corbin is seventeen, but due to a rare epilepsy syndrome “behaves like a violent toddler,” Mates says. She once spent five days in a U-M emergency room trying to get him placed for treatment (“Nightmare at the Psych ER,” January 2021), and she has never been able to find an institution that could handle him long term.

So Mates cares for him at home, with 24/7 support from two paid helpers. They’re “amazing people,” she says, but they cost the health insurance program about $300,000 a year.

Medicaid also pays for life-saving medications, mental health treatment, and equipment. In Michigan it covers 45 percent of births, and keeps some hospitals and nursing homes open.

“Given the scale of reduction in federal Medicaid funding to the states, I suspect there may be many services that are cut or limited,” says Renuka Tipirneni, a physician and researcher at Michigan Medicine. The consensus is that funds are likely to come from what may be considered optional benefits, such as dental care—and caregivers.

Patricia Rabe is worried, too. “My son at age thirty-five functions at about the age of a ten-year-old,” she says.

Despite his intellectual and developmental disability (IDD), Rabe has created a full life for him: with supervision, he is able to work at a golf course, and he lives in a condo in a supportive community. But both his work and living situations rely on caregivers paid by Medicaid.

Tipirneni is part of a team studying the impacts of the state’s Medicaid expansion over the past decade. They found there was much more preventive care, improved health, and fewer deaths. Now, she fears a reversal. “It seems likely we’ll see a lot more barriers to people accessing health care,” she says.

The bill also requires most Medicaid recipients to work or volunteer. Tipirneni says Michigan tried this briefly once and found implementing the system was expensive. In addition to the human issue, she says, “this doesn’t account for how much this will cost state governments.”

Sandee Koski’s thirty-one-year-old son with an IDD has held part-time jobs and is currently working with a Medicaid-paid agency to find another. He lives in his own apartment in Dexter, with the help of a housing voucher, food assistance, and twenty hours a week of direct care. Medicaid pays for orthopedic shoes. Without all this, Koski says, he would have to move back with his parents.

“That would rip his life apart,” she says. “We have been working since he was little toward where he is right now, living in his own place, working and volunteering, and being out in his community. A safety net existed, and we planned accordingly. One of the things we worry about as a family is that Medicaid pays his Medicare premium.” He could lose that insurance as well.

Angela Persinger’s daughter, Miranda, has quadriplegic cerebral palsy. Her sister cares for her while Persinger herself is a paid caregiver, sometimes for senior citizens who would not be able to shower without help. “Being in their homes is financially beneficial [and allows them] to stay as active and healthy as possible,” she says. “The Medicaid cuts will kill Michiganders.”

Mary Merriman cared for her brother, Pete, who had Down syndrome, for the last ten years of his life; she lost him to Alzheimer’s disease last year. She says Medicaid paid for everything from the vocational program he attended to the care workers who helped out. It paid for dental care and expensive prescriptions when he began having seizures.

“Parents of disabled people are worried about what their sons’ and daughters’ lives will look like, basically, when we are dead,” Rabe reflects. “I have paid into the system, taxes and Social Security. I have followed the rules and tried to plan for my son.”

But the safety net is being cut. The reductions are scheduled to begin shortly after the midterm elections in 2026. People may not be aware of the impact until after they vote.

Calls & Letters September 2025: Corbin is doing much better

To the Editor:

A clarification to a detail in the article about Medicaid cuts (Inside Ann Arbor, August): Thanks to a village of amazing people at school and behavior therapy, and a team of great caregivers at home, my son Corbin is much more gentle now, and thriving.

I do hope Medicaid and other programs will still be there when he needs them in the future.

Sincerely,

Valerie Mates